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Gold Shield Annual Membership Dues
(July 1, 2026 - June 30, 2027)

Payment Deadline: July 30, 2026

Annual membership dues must be received by July 30, 2026. Thank you for submitting your payment by the deadline to ensure your membership remains current for the 2026–2027 membership year.


Required fields are indicated with an asterisk (*).
RSVP Information
Membership Type

Please select the one that applies.
SelectDescriptionAmount
Active Membership - $100
Associate Membership - $100
Sustaining Membership - $100
Non-Resident Membership - $50
Sub-Total:
Tax-Deductible:

Grand Total:
Tax-Deductible:
 
Contact Information   

Personal
Title:
* First name:
  Middle name:
* Last name:
  Suffix:
   I am making this gift as a proxy for my organization/company, which should be recognized as the legal donor

Contact Information
* Street:
 
U.S. Addresses  
*   City, State, Zip:
Non-U.S. Addresses  
  Non-U.S. City/County
  or Province/Postal Code:
  Country:
* This address is my:
* Home telephone:
Business telephone:

* E-mail address:
* This e-mail is my:

Payment
Payment method:
Additional Information
 
Comments: 

     


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For questions about your Gold Shield Membership, contact UCLA Affinity Networks at affinitynetworks@alumni.ucla.edu.
Click here to view privacy policy and disclosure statements to prospective donors.
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